[Tuberculosis in perinatal stage. A challenge to the binomial care mother-son. Report of two cases]

Case report of 18-year old female patient with clinical signs of pulmonary tuberculosis during pregnancy at beginning of fourth month into term, with airway impairment, as evidenced by dry cough, fever and night sweats, as well as a 6 kg. weightloss. Twenty-two days after giving birth, the patient was hospitalized with high fever and deteriorated health conditions, requiring treatment in the intensive care unit due to complications such as severe malnutrition, septic shock, pulmonary abscess, pachypleuritis, empyema and bronchopleural fistula. The tuberculosis diagnosis was established through ABF identification with Ziehl-Neelsen stain of the pleural fluid. The patient was hospitalized for 42 days, including eleven days on a mechanical ventilator, before being discharged. Her newborn daughter was admitted to the Pediatric Intensive Care Unit on the 19th day of life due to coughing, fever, difficulty in breathing, liquid stool and rejecting food. The newborn was hospitalized in the newborn intensive care unit for twenty-two days, developing major sepsis and multiple organ failure, which complications led to her death. An autopsy was conducted, revealing granulomatous lesions consistent with tuberculosis in lungs, liver, small intestine, large intestine and peritoneum; additionally the PCR of bronchial aspirate was positive to Mycobacterium tuberculosis DNA.